Wound Healing 创伤愈合.pptVIP

???? ; ???? Wound Healing Healing process Healing process The activation of basic cellular processes of inflammation, cell proliferation, and growth as well as regulation of these processes once repair is complete. Healing process Types of wound closure Primary closure Primary closure Secondary closure Secondary closure Delayed primary closure Delayed primary closure Partial thickness wound healing TISSUE RESPONSES TO INJURY Vascular events TISSUE RESPONSES TO INJURY Cellular events platelets Neutrophils Macrophages TISSUE RESPONSES TO INJURY Chemical mediators Vasoactive agents Cytokines in wound healing TGF-β PDGF FGF EGF WOUND HEALING PHASES Inflammatory phase At the initial time of tissue disruption, platelets release coagulation factors and cytokines to initiate the healing process Within the first day following tissue injury, neutrophils attatch to surrounding vessel walls and then move through the vessel walls to migrate to the wound site Proliferative phase Angiogenesis The fibroplasia phase is characterized by movement of wound macrophages into the site of injury, which in turn attract fibroblasts. The fibroblasts then repair the site by producing new connective tissue matrix. Maturational phase ( = remodeling ) The remodeling phase is characterized by an equilibrium between collagen synthesis and collagen degradation in an effort to reestablish the connective tissue matrix. MECHANISMS IN WOUND HEALING Epithelization MECHANISMS IN WOUND HEALING Contraction MECHANISMS IN WOUND HEALING Components of extracellular matrix Synthesis of collagen FACTORS AFFECTING WOUND HEALING Types of Injury Aging In vitro – decrease in the proliferative potential of fibroblasts and epithelial cells Clinically – heal more slowly with less scarring Medications Steroids Impairing macrophage migration Altering neutrophil function Inhibit synthesis of procollagen by fibroblasts Vitamin A deficiency Impair monocyte activation Inhibit fibronectin deposition Impairment of TGF-β rece